Hemorrhoids - Hemorrhoids - Hemorrhoids

Hemorrhoids chirwere chakapararira, asi hapana anotaura nezvazvo.

Aiva sind Hämorrhoiden? 

Hemorrhoids - hemorrhoids - ma nodular dilations etsinga dzeropa mu rectum, iyo inopihwa nepakati tsinga ine high blood pressure. Hemorrhoids haisi yakajairika midziyo yekumashure, iyo inopa cushioning yekudzora stool. Hemorrhoids yatove yakasakara-yakapera rectal midziyo, izvo zvinogona kutungamirira kuprolapse yeura uye kutungamirira kune kuvuza uye mucus secretion. Nekuda kweizvozvo, hemorrhoids inokonzeresa zviratidzo zvakaita sekubuda, kushatirwa kweganda, kupisa, kuputika uye dzimwe nguva kubuda ropa. Mumutauro wehunyanzvi, mahemorrhoids ekunze anonzi "perianal veins". Perianal thrombosis kana anal vein thrombosis ibundu rinokurumidza, rinorwadza mu rectum iro rinoda kurapwa nokukurumidza.

Zvikonzero zvehemorrhoids

Zvikonzero chaizvo zvehemorrhoids hazvinzwisisike zvizere. Chikonzero chikuru chinoita semararamiro ekugara uye kusakwana kwefiber kudya. Zvokudya zvine fiber zvakadai sezviyo, saladhi, oatmeal uye gorosi bran chikamu chekudya kune utano, asi kwete vanhu vose vanoitevera. Mukuwedzera, genetic predispositions inogonawo kuita basa mukukura kwehemorrhoids.

Hemorrhoids - pamberi uye shure kwemifananidzo

Dzidza zvakawanda kuburikidza nemifananidzo pamwe nepamberi uye mushure memifananidzo nezve Mamota,  perianal tsinga, pamberi uye mushure memifananidzo nezve hemorrhoid laser kuvhiyiwa (LHPC)  uye hemorrhoid laser kurapwa, uyewo Perianal vein laser kurapwa uye Perianal thrombosis laser kurapwa muHeumarktClinic Cologne naDr. Haffner.  

Zviratidzo zvehemorrhoids?

Hemorrhoids chero ipi zvayo inogona kukonzera kubuda ropa uye kukwenya munzvimbo yekumashure. Kunewo zvakare kazhinji matambudziko nekufamba ura. Varwere vane hemorrhoids kazhinji vanofanirwa kuenda kuchimbuzi kakawanda mumutsara uye havagone kuburitsa zvese kamwechete. Kuvhara, kumanikidzwa uye kurwadziwa zviratidzowo zvinowanzoitika. Kuzora kwetsvina kunogonawo kuitika, asi izvi zvakasiyana nekusaita fecal incontinence. Nemahemorrhoids, kutadza kwechokwadi kwefecal incontinence hakuitike nekuti iyo reflexively tense deep sphincter haingodzivise hemorrhoid kubva kuprolapse, asi zvakare inodzivirira kubva kune fecal incontinence. Nekudaro, iyi mhasuru dziviriro inopihwa neakadzika pelvic pasi tsandanyama haigone kudzivirira dambudziko reiyo continence yakanaka pamucheto wekumashure. Kusakwana kweanal mumusuwo wekumashure kunozotungamira kune zvakajairwa hemorrhoid zviratidzo zvakaita sekubuda, kukwenya, kupisa uye kuzora. Iwo akazadzwa "perianal veins", anoonekwa se "varicose veins of the rectum" kana ekunze hemorrhoids, anounza dambudziko nekuti anogona kutungamira kune perianal thrombosis kana anal vein thrombosis kana kukonzera diki misodzi inobuda ropa uye inorwadza uye nekuda kweiyo iri pasi pechirwere cheHemorrhoid. zvakaoma kupora.

Kubuda ropa kubva rectum

Maererano nemirairo yeS3, kuratidzwa kunowanzoonekwa kwehemorrhoids kubuda ropa kubva mu rectum. Zvinoenderana nemirairo, kuwanda uye kuomarara kwekubuda kweropa hakuteveri maitiro ehemorrhoids ataurwa pamusoro apa. Kubuda ropa kubva murectum kunogona kuitika kunyange nediki hemorrhoids uye zvakakodzera kuzivisa varwere mukutanga kwechirwere chehemorrhoid. Sezvo pasina munhu anoda kurarama nekubuda ropa kubva mu rectum, kurapwa, e.g. B. nelaser-based operation, inotoratidzwa kune madiki hemorrhoids kana akonzera kubuda ropa kana zvimwe zviratidzo. Kubuda ropa kubva mu arterial vascular conglomerates iyo inoumba hemorrhoids inowanzo tsvukuruka. Kubuda ropa kunogona kuita kudiki, asi kunogona zvakare kurema uye kukonzeresa kudonha. Sezvo muviri wemunhu unogona kugara uchivhara rectum kuvonga kune yakasimba sphincter tsandanyama, ropa rinotanga kuunganidza mu ampulla ye rectum. Ipapo inogona kupfuudzwa muhuwandu hwakakura sechituru chitsvuku chakasviba. Perianal tsinga dzinobuda ropa kubva kumusana dzinogonawo kubuda ropa rakasvibira. Zvakakosha kuziva kuti zviratidzo zvekutanga zvekoloni uye rectal tumors zvinowanzobuda ropa. Saka, kana iwe uine kubuda ropa kubva murectum, zvinokurumidza kudiwa kushanyira proctologist muCologne uye kuve nekuongororwa nekukurumidza kunoitwa pasina chero gadziriro dzakaoma. Chinongodiwa kungofamba ura kumba usati waongororwa uye kuchenesa hutsanana.

Perianal eczema - perianal kuzvimba

Chisingaperi, chinogumbura uye chine chepfu ganda kuzvimba pane anus inonzi perianal eczema. Anoteerera proctologist achaziva ganda chena-tsvuku rine maronda madiki kusvika makuru uye akatsemuka. Ganda re perianal rakazvimba, rinoratidza kuwedzera kuunyana uye pamwe ma tag eganda anonzi ma tag eganda. Kuongororwa uku kunogona kuitwa nachiremba wemhuri kuburikidza nekuongororwa kwemaziso pasina kumwe kuongororwa: Chiremba anoona anoona ganda rakacheneruka uye rakaputirwa, rinorwadza uye rakaunyana munzvimbo inosvika 2-6 cm yakatenderedza rectum. Kana gwara rinopararira, mucus, mwando, kana dzimwe nguva tsvina yetsvina inogona kuonekwa. Vamwe varwere vanoshandisa cream nguva dzose. Kana murwere ane creamtem Apo rectum inouya kune proctologist, izvi zvinotoratidza chirwere chepamusoro chehemorrhoid.

Kukwenya netsvina, kukwenya uye kupisa mu rectum

Zviratidzo zvehemorrhoids, zvakadai sekucheka, kupisa, kurwadziwa uye kuputika mu rectum, zvinomuka nekuda kwekusakwana kweanal umo rectum isingakwanisi kuvhara zvachose uye yakaoma. Izvi zvinokonzera kutsamwa kweganda, zvakafanana nefuruwenza yakaoma, apo mhino inomhanya inoshungurudza zvakanyanya kare utano uye yakaoma ganda. Kunyange kana rectum isina kuvharwa zvachose nekuda kwehemorrhoids, zvakakwana kuti mucus mudiki kubva mugero rekumashure, iro rakafukidzwa ne mucous membrane, rinogara richipinda paganda rekutanga rakaoma uye rinorizora. Iyo yakaoma, ine hutano ganda mumusuwo weanal inorwiswa, yakakuvadzwa, inopisa uye yakazvimba, izvo zvinozoita kuti pave nekufunuka uye kupisa. Saka hazvidikanwi kuti "stool incontinence" iitike kuitira kuti unzwe kuputika uye kupisa mu rectum. Kunyange kana rectum ichikwanisa kubata chituru chakakasharara, centimita yekupedzisira pamusuwo wekumashure inogona kuvhara zvisina kukwana kana kuvharika zvachose kusingagoneki nekuda kwekuwedzera kwehemorrhoids. Izvi zvinokonzeresa kuti mucus uye hunyoro kutiza kubva kune yakajairwa mucous membrane, iyo inozotungamira kune yakajairwa yekunze ganda, iyo isingakwanise kushivirira mucus kwenguva refu.

Kuputika kwemahemorrhoids

Kuita kwaGoligher kwemahemorrhoids kunoratidza zvisiri izvo kuti hemorrhoids inokonzera dambudziko rimwe chete, prolapse. Iyi nhanho yechinyakare inopa fungidziro yekuti kuomarara kwechirwere chehemorrhoid uye zviratidzo zvinosanganisirwa zvinoenderana chete nedhigirii remukati hemorrhoid prolapse. Kubuda kwemahemorrhoids ekunze, thrombosis yekunze kwehemorrhoids, kusakwana kwemashure, kusagadzikana kwecontinence, kubuda ropa, kunyorova nekukwenya pamwe neeczema yeganda hazvicherechedzwe. Kunyangwe nhungamiro yeS3 kuGermany yakatora iyi nhanho yechinyakare uye inoratidza zviratidzo zvekuvhiyiwa zvichibva pane iyi yechinyakare staging yemahemorrhoids. Goligher's staging yehemorrhoids inongofunga nezve prolapse yemukati hemorrhoids. Zvisinei, mumakiriniki eproctology, varwere vanowanzouya nekuputika kwemukati nekunze kwehemorrhoids pamwe chete nematagi eganda, ayo anonzwa sebundu rinoputika pa anus uye kukanganisa hutsanana hwemashure uye kubuda. Kana thrombosis yekunze kwemahemorrhoids kana kugara kushatirwa kweganda kumucheto weprolapse kunoitika, varwere vanowanzoshuvira kubviswa kwakapfava uye kusingarwadzi, zvisinei nekuti mukati mehemorrhoids iri nhanho II kana III. Vanosvika 90-95% yevarwere vanotsvaga rubatsiro nekuda kwebundu rinopenya pa rectum, rinoratidza se thrombosed perianal vein. Vanenge 10% chete yevarwere vanotsvaga rubatsiro kune prolapsed hemorrhoids, iyo inofanirwa kupota ichisundirwa kumashure nemunwe. Skin tags semapundu pane anus chikonzero chinowanzoshanyira proctologist, uye varwere vakawanda vanoda kurapwa pasina kuvhiyiwa, semuenzaniso. B. kuburikidza nelaser kurapwa.

Anal fissure

Misodzi yeAnal inogona kuitika nekuda kwekutambanudza kwakanyanya kana pasina kukuvara kwekunze nekuda kwekupfava uye kuzvimba perianal ganda uye mucous membrane. Iwo makatsemuka anogona kuitika ese ari maviri mumusuwo wekumashure seakareruka anotsemuka kana seakatsemuka madiki uye maronda akatenderedza rectum. Ganda rinoputika, kuputika uye maronda zvinorwadza zvikuru zvose zvakangoerekana zvaitika uye nekubata kuduku. Nekuda kwekusangana kweropa muhemorrhoids uye perianal veins, mucous membrane inoputika sebharumu. Ipapo guchuru rakazvimba rinobvaruka sebharumu kana chituru chiri kukwenya. Inflamed uye eczematous perianal ganda harina kusimba pane ganda rine hutano. Naizvozvo, hemorrhoids inogona kutungamira mukutsemuka kweanal nekuda kwekukuvadzwa kweganda uye yakatetepa yakatetepa ganda uye mucous membrane. PaHeumarktClinic Proctology muCologne, hapana maitiro anoshungurudza anoitwa anonetesa sphincter uye, maererano neproctology ruzivo mapepa anokurudzirwa muGermany yose, inogona kunge iri chikamu chekuvhiya chirongwa cheakanakisa proctologists muCologne. Sezvo misodzi yekumashure isiri chirwere chakazvimirira mupfungwa yechokwadi, asi mhedzisiro yehemorrhoids, inofanirwa kurapwa sechikamu cheiyo iri pasi pechirwere chehemorrhoid. Uye izvo zvisina kucheka, mapanga kana chigero, asi nelaser irradiation muHeumarktClinic Proctology muCologne. Kunyanya, incising kana kucheka sphincter pamwe nekucheka kubvarura sezvakakurudzirwa mubepa reruzivo hazvikurudzirwe.

Marwadzo mu anus uye rectum

Hemorrhoids pachayo haikonzeri kurwadziwa! Varwere vanowanzouya kune yedu yakavanzika proctology kubvunza muCologne vanoshamisika apo proctologist inovaudza kuti ivo vakawedzera hemorrhoids, izvo zvinokonzeresa unyoro, kuzvimba, kuvava uye kupisa uye nekukurumidza zvinoda kurapwa. Nekuti mahemorrhoids haakonzerese marwadzo, anowanzo shivirira, kunyangwe akadonha panguva yekufamba uye pano neapo anoda kusundirwa kumashure. Varwere vanojairana nemamiriro erectum yavo, sezvo mamiriro acho achingochinja zvishoma nezvishoma mumakore mazhinji uye anogona kunyanya kubhadharwa neachiri yakasimba sphincter tsandanyama. Zvinoshamisa kune proctologist kuti varwere vazhinji havaoni eczema uye kuzvimba kweganda re perianal. Vanhu vazhinji vanoita sevasina basa nazvo dzimwe nguva asi inoenda ne "good hemorrhoid mafuta". Vamwe havatombo zviona kana kuzvimba kwasvika kubhonzo remuswe kana kumberi kwemboro kuvarume kana kuvhura beche kuvakadzi. Vanhu vazhinji havaone kuvimba kwavo nemafuta ehemorrhoid sechirwere uye vanofunga kuti iganda rinokwenya zvishoma.

Marisques

Mateki eganda kana maflaps ma tag eganda pamusuwo wekunze wekumashure, munzvimbo yeanus. Mukupesana ne mucosal appendages kana polyps muura kana mugero wekumashure, ma tag eganda matishu eganda. Kuumbwa kwemategi eganda kunogona kukonzerwa nezvinhu zvakati wandei, zvinosanganisira kubuda kwe mucous membrane, micro thrombosis ye perianal veins, kana musanganiswa wezvose zviri zviviri zvinhu. Kutsamwiswa kweganda nekuda kwekunyorova uye kuvhiringidzika kwecontinence yakanaka kunobatsirawo pakuumbwa kwemavara eganda. Ma tag eganda anogona kunetsa kune vanhu vazhinji, kunyanya nekuda kwezvikonzero zvekunaka, kunyangwe zvisingakonzere kurwadziwa. Kana murwere auya kuproctology muCologne nekuda kwekurwadziwa kwakanyanya, 90% yeavo vakabatwa vatove nemarwadzo akanyanya ekumashure. Sezvatotaurwa, kutsemuka hakuitike pasina chikonzero, asi kunokonzerwa nekubvaruka perianal tsinga dzinokonzerwa nekukakavadzana kwakanyanya kana kukuvadzwa, kutsva ganda rekunobuda nako muzviitiko zvekusakwana kweanal uye hemorrhoids. Kamwe kamwe kurwadziwa uye kuvapo kwechirungu chinoputika pa rectum chinoratidza thrombosis yehemorrhoids kana perianal veins.

Anal spasm uye continence disorder

Lord's anal spasm chiratidzo chekare chehemorrhoids iyo yakarapwa neinodhiriza yekumashure munguva yemuvambi. Kunyange nanhasi, anal dilators ichiri kushandiswa kana rectum yakanyanyisa zvokuti kune rumwe rutivi inokonzera kurwadziwa kwakanyanya, dzimwe nguva inonzi "proctalgia fugax", uye kune rumwe rutivi inotungamirira kukuvhiringidza mukubvisa rectal. Muchidimbu, rectum haigone kuvhura zvakanaka uye saka haigone kuburitsa zvachose. Mumwe anogona kubvunza kuti sei ese ari maviri spasm uye anol leakage achionekwa senge mahemorrhoids. Idzo tsandanyama dzetsvina hadzina kusimba uye hadzina kukwana here kana kuti dzakanyanya kusimba? Tsananguro yeizvi ndeiyi inotevera: Mu proctology muCologne hatitauri nezve sphincter, asi nezve sphincters. Iyo sphincters inogona kukamurwa kuita mapoka maviri makuru emhasuru ane mabasa akasiyana uye mabasa ane chekuita necontinence:

A/ Fine continence: Responsible = superficial sphincter muscles (external sphincter, internal sphincter)

Munyaya yehemorrhoids, kushaya simba kwepamusoro-soro mhasuru dzinogona kuonekwa neanal manometry. Chikonzero cheizvi ndechekuti mahemorrhoids anokwira mugero rekumashure, izvo zvinosiya nzira yekumashure yakavhurika zvishoma uye mamhasuru haakwanise kuchengetedza kudzvanywa kwehemorrhoids. Izvi zvinotungamirira mukuvhiringidzwa mu continence yakanaka, inoratidzwa nekunyorova, kuzora uye kuchenesa. Kana hemorrhoids ichibva yabviswa pachishandiswa laser, HAL, RAR, nezvimwewo pasina kuchekwa, mupendero wekumashure unogona kuvhara zvirinani zvakare uye kunyorova nekukwenya kunogona kumira. Dzimwe nguva endo-anal biofeedback kudzidziswa kwemhasuru dzekumashure kunodiwa zvakare, izvo zvinoitwa kungave kuburikidza nepelvic pasi maekisesaizi kana nerubatsiro rwechigadzirwa chezvino chinosimudzira.

B/ Gross continence: Responsible = deep sphincters (M. Puborectalis, Levator ani)

Iyo yakadzika sphincters inova nechokwadi chekuti chikamu chepamusoro che rectum chinovharika zvine mutsindo kana hemorrhoids ichidonha. Sekureva kwaIshe, chisingaperi cramp uye spasm yeyakadzika sphincters ine kusagadzikana kwekuita tsvina nekuda kwekuvharika kwekuvhurwa kweanal zviri pakati pezviratidzo zvemhando yepamusoro hemorrhoids, zvisinei nekuti hemorrhoids inogona kusundirwa kumashure nemunwe kana kwete. Panyaya yechirwere chehemorrhoidal chepamusoro chine spasm, kurapwa saka kunosanganisira kutambanudza yakadzika basal tsandanyama (levator uye puborectalis) uye kubvisa hemorrhoids sechikamu chehemorrhoid maitiro. Kana izvi zvikasaunza kuvandudzwa kwenguva refu, iyo HeumarktClinic Proctology muCologne inopa yakakosha, inodzorwa neultrasound, yakanangwa jekiseni reyakadzika pelvic pasi tsandanyama ine muscular relaxant kusunungura cramp kweinenge mwedzi mitanhatu uye kugonesa kubuda kwakajairika. .

kusakwana kwetsvina

Anal insufficiency zvinoreva chirwere checontinence yakanaka. Zvinoenderana negwaro reS3 remasangano eGerman nyanzvi yeproctology uye colon-proctology, kudonha kwemahemorrhoids kunotungamira kune yakanyorova uye dzimwe nguva kunyange kuburitsa fecal, iyo inogona kutanga yaonekwa seinoyerera, asi gare gare sechituru smearing uye inogona kupedzisira yakonzera kune yakasviba chipfeko chemukati. Unyoro hunogara huripo hunotsamwisa perianal ganda zvachose. Zvinenge zvisinganzwisisike kuti hutsanana hwakaoma uye husingazorodze musana haupihwe uye kuti vanhu vazhinji havaoni zvitsiga pazvipfeko zvavo zvemukati sechiratidzo chekuti pane chakashata nerectum. Izwi rekuti "anal insufficiency" - fine continence disorder - ishoko rekunze kune veruzhinji, izvo zvinoreva kuti "hazvindikanganise" nekuti "Ndichiri kugona kudzora chituru changu".

Perianal thrombosis - anal thrombosis

Perianal thrombosis kana anal vein thrombosis inoitika apo ropa rakaunganidzirwa mutsinga dzakatambanudzwa dziri kumucheto kunobatana. Bundu rinorwadza rinoumba pamucheto we anus. Kugara uye kuita tsvina kunorwadza. Iyo perianal thromboses inowanzoputika uye kubuda ropa kunogona kuitika. Marwadzo, mapundu anorapika uye kubuda ropa kunoita kuti varwere vakurumidze kutsvaga kurapwa. Zvakakosha kuziva kuti thromboses pamucheto wekumashure inongova zviratidzo zvekunze zvinoonekwa zvemukati hemorrhoids. Munyika dzinotaura Chirungu, mutsauko unoitwa pakati pekunze uye mukati mehemorrhoids, iyo inomiririra zvikamu zviviri zvechirwere chehemorrhoidal. Pasina mukati mehemorrhoids, kunze kwehemorrhoids haigadziri uye thrombosis ye perianal veins munzvimbo yekumashure haiitike. Dzimwe nguva thrombosis yemukati uye kunze hemorrhoids inoitika, inogona kurwadza zvakanyanya uye inoda kukurumidza kurapwa kweproctological.

Chii chaunofanira kuita kana uine hemorrhoids? 

Kana iwe uine zviratidzo zvakaita sekukwenya, kupisa, kuzora kana kubuda ropa munzvimbo yekumashure, unofanirwa kushanyira nyanzvi yeproctology kuCologne kuti uongororwe rectum yako uye kuti uongororwe uye kuongororwa kwegomarara kuitwe. Mushure mekuongororwa, unogona kuwana mazano pamusoro penzira dzakasiyana-siyana dzokurapa, kusanganisira nzira dzekuchengetedza dzakadai se rubber band ligation, sclerotherapy, kutonhora, pamwe chete nenzira dzekuvhiya dzakadai seHAL nzira, THD, RAR nzira, submucosal ligation uye ligature excision. Mukuita kwedu proctology muCologne, tinotanga tsananguro yeanogona kurapwa nelaser therapy nekuti isu tine chokwadi chekuti laser ndiyo yakanakisa nzira. Nerubatsiro rwelaser tekinoroji, kunenge kusingarwadze kuvharwa kurapwa kwehemorrhoids kunogona kuitwa pasina hukuru hwekuvhiya.

Iyo LHPC - Laser Hemorrhoid Plastic Surgery

Anenge makore matatu apfuura takatanga laser hemorrhoid plastic surgery mushure mekunge Dr. (H) Haffner akange apedza kosi yekuvhiya laser kuBio-Litec. Pakutanga, takaita nzira yacho maererano nekurudziro paBio-Litec LHP webhusaiti. Nekudaro, nekufamba kwekurapa zvakava pachena kuti laser beam inogona uye inofanirwa kushandiswa nenzira dzakasiyana siyana kuti uwane mhedzisiro iri nani. Isu takagadzirisa nzira uye zviridzwa zvinoenderana. Iyo nzira nyowani yakagadzirwa pasi pezita rezita rekuti Laser Hemorrhoid Plastic Surgery (LHPC). Hwaro hweLHPC hwakagadzirwa nesainzi kuburikidza netsvakiridzo yekuongorora mhuka ichibatsirana neExperimental Surgical Institute paUniversity yeSemmelweis. Aya ndiwo magadzirirwo akaitwa nzira nyowani yelaser yekuvhiya hemorrhoid seLHPC, laser hemorrhoid plastiki kuvhiyiwa muCologne, yave iyo yakajairwa kurapa kune ese marudzi nematanho ehemorrhoids mukuita kwedu.

Zvakanakira zveLHPC:

- Hapana kucheka - hapana matambudziko ekupora ronda - kashoma chero kurwadziwa
-Kusimbisa pane kunetesa sphincter
– Kuvandudzwa kwekufamba ura zvichienzaniswa nekare
- Zvirinani continence zvichienzaniswa nekare
-Kutora chikamu munzanga pakarepo

Pamberi pekugadzwa kweLHPC, kuongorora kwekutanga kwe ultrasound kunoitwa, panguva iyo iyo yese network ye arteri uye tsinga inoratidzwa uye zvichemo zvako zvakananga zvinojekeswa. Laser hemorrhoid kuvhiyiwa kwepurasitiki kunoitwa pahwaro hwekunze pasi pepfupi general anesthesia kana kuti twilight kurara. Local anesthesia uchishandisa nzira ye tumescent inongokwana kune madiki hemorrhoids.

LHP laser hemorrhoidoplasty

Yekutanga LHP Laser Hemorrhoidoplasty****, yakavakirwa pakuvhara tsinga dzinopa hemorrhoids netarisiro yekuti izvi zvinozoita kuti mahemorrhoids adzoke. Poshi kliniki kuedza kuLHP muUSA ClinicalTrials.gov  panhamba NCT03322527 EN PARADES Vincent, MD muna 2018 zvaitwa, asi hapana mhedzisiro iripo. Zvakadaro, zvimwe zvinyorwa zveLHP zvakatsikiswa nezvibereko zvakanaka. Iyo yeGerman S3 nhungamiro, sezvakataurwa muÄrzteblatt, ichiri kukurudzira kuvhiyiwa kwakajairika nemapanga uye zvigero zvekurapa mahemorrhoids epamusoro, sezvo kuchine zvishoma zvinyorwa uye zvidzidzo zvinodzorwa pamusoro pelaser neredhiyo wave nzira, kunyangwe mabhuku ega ega nevanyori vanotaura mhedzisiro yakanaka. 

HAL, THD uye RAR nzira

HAL, THD uye RAR inzira dzekurapa dzeproctological dzinobva pane dzakakosha suturing matekiniki. Pfungwa yekutanga yeese nzira ndeyekudzikisa mahemorrhoids nekucheka ropa. Munzira yeHAL, tsinga imwe chete inowanikwa neDoppler ultrasound probe uye yakasungwa ne ligature. Munzira yeTHD, tsinga huru dzese dzehemorrhoids dzakasungwa nedenderedzwa suture parutivi rwerectum. Chinangwa cheiyo THD nzira, sekureva kunoita zita, ndeyekubvisa hemorrhoids nekumisa tsinga dzese dzakakosha dzeropa. Nenzira yeRAR, mahemorrhoids anotanga kudzivirirwa, sezvakaita nzira yeHAL. Zvisinei, mushure mekubatanidza tsinga huru, maitiro anoenderera mberi nekusunga mashizha ehemorrhoid nemamwe ligatures uye kusimbisa mucous membrane. RAR ligation uye kuomesa zvinowanzobatanidza tambo ina huru dzehemorrhoids. PaHeumarktClinic Proctology muCologne, ese aya maitiro ekugadzira suturing anoshandiswa nemakore mazhinji echiitiko uye kubudirira. Chiitiko chedu chakaratidza kuti kusanganisa nzira idzi nelaser irradiation yehemorrhoid mass inonyanya kushanda. Muchidimbu, zvinogona kutaurwa kuti HAL-RAR-THD pamwe chete nelaser ndiyo inonyanya kushanda uye yakapfava kurapa imwe nzira muproctology. Hapana kuchekwa kunoitwa, izvo zvinoderedza njodzi yematambudziko.

Kuparara, kusungirirwa nemabhande erabha uye icing

ndiyo inonyanya kushandiswa nzira dzekurapa dzekunze dzehemorrhoids muproctology, zvese neproctologists uye proctologists muCologne. Mishonga iyi iri nyore uye kazhinji hairwadzi. Sclerotherapy inosanganisira kubaya jekiseni re sclerotherapy munyama yehemorrhoid, izvo zvinoita kuti iite shoma. Zvisinei, kune mamwe mahemorrhoids akaoma, nzira iyi haigutsi uye kudzokazve kunogona kuitika. Rubber band ligation inosanganisira kusunga pfungwa imwe chete yehemorrhoid, asi izvi zvinowanzoshanda. Muproctology paHeumarktClinic muCologne, musanganiswa weidzi nzira unoshandiswa kukwirisa budiriro uye kuderedza mhedzisiro. Ipfundo rimwe chete rinosungirirwa panguva uye sclerotherapy inongoiswa muchikamu chakasungwa kuitira kuti udzivise mhedzisiro yakadai semavanga kana kuomarara kwemadziro emukati ane hutano. Pfundo rinogadziriswa rinobva raiswa aizi nepenzura inotonhora nechando. Nekusanganiswa uku, varwere veHeumarktClinic Proctology muCologne havana marwadzo panguva uye mushure mekurapwa uye mhedzisiro diki senge kushoma uye kushoma zvakanyanya kubuda ropa kwechipiri. Matambudziko akadai seabscesses kana fistula, ayo akataurwa nevamwe proctologists, haana kumbobvira aitika nesu mushure mekurapa uku.

Ndeipi mafuta akanakisa ehemorrhoids

Mafuta akanakisa ehemorrhoids anosiyana zvichienderana nezviratidzo zvemunhu uye mamiriro enzvimbo yekumashure. Chizoro chakanaka chehemorrhoid chinofanira kuva nekurwadziwa-kubvisa, kutonhora uye kudzikamisa maitiro. Inogona kunge iine zvinhu zvechisikigo zvinovandudza kusimba kweganda rekumashure uye kukurudzira kuporeswa kwemaronda. Mafuta akanaka anofanirawo kuita semafuta panguva yekufambisa ura pasina kunamatira pachipfeko chemukati. Zvakakosha kuti chizoro hachikonzeri zvinokonzerwa nehutachiona uye hazvina kwazvakarerekera.

Mugadziri anowanzopa mushandisi anogona kushandiswa kuisa zvinyoro zvinyoro mafuta ekuzora mugero rekumashure. Sarudzo pakati pe gel, suppositories kana chizoro zvinoenderana nezviratidzo zvega, sekurwadziwa, kubuda ropa, kuputika kana kupisa, pamwe nemamiriro enzvimbo yekumashure. Iko hakuna pese pese mafuta ekuzora kune ese marudzi uye nhanho yehemorrhoids. Zvinokurudzirwa kutsvaga mazano uye kuongororwa kubva kune proctologist. Mafuta anozora akakodzera chete kuderedza zviratidzo uye haagoni kurapa hemorrhoids. Ichi ndicho chikonzero sirogani yekushambadzira "Laser ndiyo yakanakisa hemorrhoid mafuta" yakagadzirwa, sezvo kurapwa kwelaser kunogona kunyatso kudzikisa hemorrhoids uye nekudaro zvakare kudzoreredza zviratidzo.

Muchidimbu: Mafuta anozora anobatsira, asi marapiro elaser anoporesa.

Kuvhiyiwa kwehemorrhoid kunoratidzwa riini? 

The staging of hemorrhoids maererano naGoligher kubva muna 1980, iyo yaimboshandiswa kuona chiratidzo chekuvhiyiwa, ndeyekare. Iyi kupatsanurwa hakufungi nezve zvese zviratidzo uye madhigirii ekuomarara kwechirwere chehemorrhoidal. Izvo zvichiri kukurudzirwa kuita oparesheni chete kune advanced stage III kana IV kesi apo hemorrhoids inoputika uye inoda kusundirwa kumashure nemunwe. Iyi kupatsanurwa kwakaomarara kwakaruramiswa munguva yakapfuura apo maoparesheni akakomba aiitwa nemapanga uye anesthesia yaive riskier.

Nhasi, zvakadaro, nzira dzakapfava uye dzinoshanda senge laser kurapwa dziripo. PaHeumarktClinic Proctology muCologne, chinotariswa chiri pakutambudzika kwemurwere uye zviratidzo. Therapy ine chinangwa chekubvisa zviratidzo, zvisinei nedanho rehemorrhoids. Goligher's old staging haienderane nezviratidzo uye kutambura kwevarwere. Mitsara mitsva uye nzira dzekurapa dzinofunga nezvezviratidzo zvakasiyana sekubuda ropa, prolapse, thrombosis uye matambudziko eganda (kurumwa, kupisa, kubuda, eczema) pamwe ne thrombosis yekunze perianal tsinga. 

Nekuti iyo yekare nhungamiro uye giredhi yekuomarara kwehemorrhoid haifukidze zviratidzo zvinoonekwa nevanhu, giredhi nyowani yekuoma kwehemorrhoid inoda kugadzirwa (4,5,6,7). Iyo itsva hemorrhoid severity classifications haishandisi chete kurapwa kwemukati hemorrhoids, asiwo kurapwa kwe "kunze" hemorrhoids uye zviratidzo zvinowanzoitika. Semuenzaniso, nhoroondo yekubuda ropa inotorwa muchikamu che "PNR-Bleed" pakugadzirisa kuoma (7). Ne BRST staging maererano neSobrado (4), nzira itsva dzekurapa pamwe chete nezviratidzo zvakakosha zvehemorrhoids yepamusoro zvinotorwa pakuona zviratidzo zvekuvhiyiwa, sezvinotevera: kubuda ropa (B), prolapse (P), ganda (S) zvinetso uye thrombosis migumisiro (T) kunze hemorrhoids.

Laser kurapwa anogona zvinobudirira kubata zvose mukati uye kunze hemorrhoids uye kudzivirira matambudziko. Yave nguva yekuti proctology itarise pane mitsva mitsva uye zvinyoro nzira dzekurapa dzakadai sekushandiswa kwema lasers.

Chiratidzo chekushanda kwehupenyu hwezuva nezuva

vari kubuda ropa, maprolapses makuru kana rectal strictures. Kusakwana kwetsvina, kuzora chituru, kuchema, kupisa, perianal eczema, kurwadziwa, kutsemuka kwetsvina kana thrombosis zvakare mhedzisiro yechirwere chehemorrhoid. Iyi mhedzisiro yakakomba inopfupikiswa se "advanced hemorrhoid chirwere" uye chiratidzo chakakwana chekuvhiya. Nekudaro, chinangwa chekushanda nhasi chinofanirwa kunge chiri chekushomeka. Kana hemorrhoids inogona kubviswa zvishoma uye pasina njodzi huru uchishandisa laser kana imwe nzira, saka dzimwe nzira dzekare hadzichadiwi.

Neimwe nzira, unofanira

Sclerotherapy kana rubber band ligatures yehemorrhoids

inofanira kufungwa, asi migumisiro yavo haisviki pakubudirira kwekuvhiyiwa kwehemorrhoid uye naizvozvo haina kukwana pakurapa kwekupedzisira kwechirwere chakakomba, chepamusoro chehemorrhoid. Maererano nezvinyorwa, nzira dzisiri dzokuvhiya dzinewo migumisiro yakakomba.

Hemorrhoids uye thrombosis panguva yekuzvitakura

Chikonzero chiripo chiripo chemukati hemorrhoids, iyo iri pasi pekumanikidzwa kwakanyanya kwepamuviri panguva yekuzvitakura. Migumisiro ndeye prolapse uye thrombosis. Kurapa kwepamuviri thrombosis kunogara kuripo uye kunoenderana nekuti ndiani ari kurapa mukadzi ane pamuviri, chii chiitiko icho proctologist ine uye kuti mangani mazuva aripo kusvika zuva rakakodzera. Anesthetics kazhinji haibvumirwe uye hapana mishonga inonyaradza marwadzo inogona kupihwa. Ko thrombosis inorwadza zvikuru inofanira kubviswa sei? Kuti tipindure mubvunzo uyu wakaoma, tinogona chete kugovera chirongwa chedu chekurapa uye ruzivo: Thromboses kazhinji inokonzeresa kutambura kwakanyanya panguva yekuzvitakura uye zvinogona kukanganisa uye kurwadza panguva yekuzvarwa. Naizvozvo tinoedza kubatsira mukadzi ane pamuviri nekuvhiya zvinyoronyoro, zvishoma. Izvi zvinoda kukwanisa kupa anesthesia yemunharaunda isingarwadzi pasina anesthetics. Chechipiri, hapafanirwe kuve nekubuda ropa, kusabuda kwechipiri uye kurwadziwa kushoma sezvinobvira mushure mekuvhiyiwa. Nechinangwa ichi, tinopa laser-kubatsirwa kubvisa pamuviri thrombosis kubva mini-incision, izvo zvinongokonzera kushoma kwepashure marwadzo, izvo zvakaitika zvakaratidza kuti zvinogoneka. Zvinetso hazvitarisirwi. Nekudaro, isu tinopa zano pamusoro pemaitiro makuru ehemorrhoid; izvi zvinofanira kuitwa mushure mokuberekwa.

Chii chaunofanira kuita kana uine kunze hemorrhoids?

External hemorrhoids vane hemorrhoids Matsinga kunze kwe anus kukanganisa, ndosaka ekunze hemorrhoids anonzi pianal tsinga. Aya mahemorrhoids anogona Kubuda ropa, mitswe uye itching uye pamusoro pezvose kazhinji perianal thrombosis / anal vein thrombosis chikonzero. Iwo ekunze hemorrhoids haagone kudzimwa kana kusungwa nekuti anotungamira kune acute complication - thrombosis. Iwo ekunze mahemorrhoids anogona kungobviswa zvishoma, achikanganisa miranzi midiki yekunze hemorrhoids / perianal tsinga. Zvisinei, izvi zvinorwadza zvikuru. Kubvisa kwakanakisa, kwakazara uye kwechigarire kwe perianal veins - ekunze hemorrhoids - inoitwa nelaser paHeumarktClinic. Iyo HeumarktClinic inoshanda mukubvisa laser kwekunze uye mukati hemorrhoids pasina kucheka kana kurwadziwa kukuru. Panyaya ye thrombosis yekunze hemorrhoids / perianal veins, iyo laser nzira ndiyo yakanyanya kunaka kana iwe uchida kuti perianal tsinga dzibviswe zvachose. Nekudaro, madiki thromboses anogona zvakare kugadzirisa ega asi anogona zvakare kudzoka kana perianal tsinga / ekunze hemorrhoids isina kubviswa. Vanhu vanobatwa vanozoperekedzwa muhupenyu hwavo hwese nekudzokorora perianal thrombosis kubva mutsinga dzeperianal dzisina kubviswa.

Mutengo Wekurapa Hemorrhoid

Ese bvunzo uye marapirwo anoitwa mudhipatimendi reproctology reHeumarktClinic muCologne zvinoenderana nehurongwa hwekubhadhara. Nehurombo, hapana chaiyo inotsanangura nhamba yekuvhiya hemorrhoid laser mutafura yemubhadharo. Naizvozvo, tsika iyi inoshandisa nhamba 2886 nemacharges ayo, iri muhurongwa hwemubhadharo wemasevhisi akafanana ekurapwa kwelaser tsinga dzakafanana dzeropa uye, sekureva kweGerman Medical Association, ndeyechokwadi kune laser irradiation yeropa tsinga. Yakawanda sei iyi iyo kambani yeinishuwarenzi yehutano inovhara inosiyana mune imwe neimwe kesi. Isu tinokupa iwe fungidziro yemutengo wekuvhiya hemorrhoid laser, iyo iwe yaunogona kukurukura nemupi wako weinishuwarenzi yehutano uye kuwana mari yekusimbisa. Bhiri reGOÄ rinobhadharwa nevanozvibhadharira kana kukumbira vanhu vane inishuwarenzi yepamutemo; Kune avo vane inishuwarenzi yakazvimirira, zvizhinji zveizvi zvinodzoserwa neinishuwarenzi yehutano yakazvimirira.

Tsvaga zvimwe uye ronga nguva yekubvunzana parunhare pa: 0221 257 2976 kana na Online appointment booking - kunyange kunze kwemaawa ekushanda. Bata neemail pano.

Zvinyorwa:

1. Goligher JC. Hemorrhoids kana mirwi. Mu: Goligher JC, Duthie HL, Nixon HH, vapepeti. Kuvhiya kwe anus, rectum uye colon.4th ed. London: Baillière Tindall; 1980. p. 96.Google Scholar]

2. Yakareba shanduro yeS3 nhungamiro 081/007: Chirwere cheHemorrhoidal ikozvino. Kubva pa: 04/2019 rakabudiswa ne: AWMF - Nyoresa Nhamba 081/007 Kirasi: S3 DSangano reGermany reColoproctology (DGK),

3. Gerjy R, Lindhoff-Larson A, Nystrom PO. Giredhi reprolapse uye zviratidzo zvehemorrhoids hazvina kunyatso kurongeka: mhedzisiro yealgorithm yealgorithm muvarwere ve270. Colorectal Dis. 2008;10:694–700. [PubMed] [Google Scholar]

4. Sobrado Júnior CW, Obregon CA, E Sousa Júnior AHDS, Sobrado LF, Nahas SC, Cecconello I. A New Classification yeHemorrhoidal Disease: Kusikwa kwe "BPRST" Staging uye Kushandiswa Kwayo muClinical Practice. Ann Coloproctol. 2020 Aug;36(4):249-255. doi: 10.3393/ac.2020.02.06. Epub 2020 Jun 1. PMID: 32674550; PMCID: PMC7508483.

5. Rubbini M, Ascanelli S, Fabbian F. Hemorrhoidal chirwere: inguva yegadziriro itsva? Int J Colorectal Dis. 2018;33:831–3. [PubMed] [Google Scholar]

6. Rubhini M, Ascanelli S. Kuronga uye mirayiridzo yechirwere chehemorrhoidal: ikozvino uye ramangwana. World J Gastroinest Surg. 2019;11:117–21. [PMC free article][PubMed] [Google Scholar]

7. Mudassir Ahmad Khan, Nisar A. Chowdri, Fazl Q. Parray, Rauf A. Wani, Asif Mehraj, Arshad Baba, Mushtaq Lawa “PNR-Bleed” classification and Hemorrhoid Severity Score—novel attempt pakuronga mahemorrhoids  DOI: 10.1016/j.jcol.2020.05.012 Journal of Coloproctology (JCOL) ISSN: 2237-9363 40. Nyaya 4.Mapeji 311-440 (Gumiguru - Zvita 2020)

8. Murie JA, Sim AJ, Mackenzie I: Kukosha kwemarwadzo, pruritus uye tsvina sezviratidzo zvehemorrhoids uye mhinduro yavo kune hemorrhoidectomy kana rubber band ligation. Br J Surg 1981; 68(4): 247–9.

 

 

Terms:

* HAL nzira= Hemorrhoidal artery ligation maererano neMorinaga 

** nzira yeTHD= Transanal hemorrhoidal arteries ligation - yakawedzera Morinaga maitiro

*** RAR nzira =Clinical.Trials.gov Clinical Trial Nha  NCT01301209, 

****LHP  = Laser Hemorrhoidoplasty: https://clinicaltrials.gov/ct2/show/NCT03322527 Study by DE PARADES Vincent, MD for Stage 2 uye 3 Hemorrhoids 

*****LHPC = Laser Hemorrhoids Plastic Surgery - Dr. (H) Haffner (Cologne) akashandisa yakagadziridzwa laser skeletal maitiro ehemorrhoids mumatanho ese. Kuedza kwemhuka uye data yekiriniki iripo. Inoshandiswa nemhedzisiro yakanaka mukuvhiya kwehemorrhoid inodarika mazana mashanu ine mwero wakaderera wekunetsekana, pahwaro hwekunze uye pasina kana kurwadziwa.